The Diabetes Attitudes, Wishes, and Needs (DAWN) Program: A New Approach
to Improving Outcomes of Diabetes Care

The Diabetes Attitudes, Wishes, and Needs (DAWN) program is an
international partnership effort to improve outcomes of diabetes care by
increasing the focus on the person behind the disease, especially the
psychosocial and behavioral barriers to effective diabetes management. DAWN
was initiated by an international survey of > 5,000 people with diabetes
and almost 4,000 diabetes care providers. The DAWN program has facilitated a
number of concrete initiatives to address the gaps in diabetes care identified
by the DAWN study.

Why Do We Need DAWN?

Diabetes is one of the major world health problems. Recent estimates from
the World Health Organization predict that if current trends continue, the
number of people with diabetes will more than double, from 176 to 370 million
people by 2030.1
Diabetes is already the single most costly health care problem in Westernized
countries. Among those diagnosed with the disease, at least half still do not
achieve satisfactory glycemic control, despite the availability of effective
treatments.2 As a
consequence, millions of people with diabetes are at elevated risk of
suffering needlessly from serious complications of the disease. With the
growing number of people with diabetes, there is an urgent need to find better
ways of curbing the human and economic burden of this chronic progressive
disease, through prevention, detection, and treatment. A review of the
literature suggests several important areas that have the potential to address
these problems.

Suboptimal diabetes self-management has been identified by several studies
as one of the possible causes of poor outcomes of diabetes care in general
practice.3,4
A multitude of research studies, mainly in the Western world and with
relatively small patient samples, has indicated the potential importance of a
multitude of psychological, social, and behavioral factors for patient
self-management.5,6Access to patient-centered self-management support and education has …